Sertraline may be more effective than cognitive behavioral therapy (CBT) for treating depression in patients on dialysis, according to a study at Kidney Week 2018. Another study found elevated heart risks with selective serotonin reuptake inhibitors (SSRIs) with greater QT-prolonging effects.
Almost one-quarter of patients on dialysis have depression, but many don’t receive treatment, said Rajnish Mehrotra, MD, professor of medicine at the University of Washington in Seattle. One obstacle has been the dearth of data on depression treatment in patients on dialysis, who are typically excluded from clinical trials of antidepressants in the general population, noted Magdalene Assimon, PharmD, PhD, a postdoctoral fellow at the University of North Carolina Kidney Center in Chapel Hill. There have been few studies specifically exploring the comparative efficacy or safety of antidepressant therapies in patients on dialysis.
“We extrapolate both efficacy and safety evidence [from trials in other populations], which may or may not apply to patients on dialysis because of their unique situation with drug pharmacokinetics and their cardiovascular burden,” Assimon said.
But the two studies presented at Kidney Week 2018 may help begin to close the knowledge gap.